The midwife at the centre of professional misconduct
allegations will know her fate this morning, after the Health
Practitioners Disciplinary Tribunal retired to deliberate in
Queenstown last night.
The woman, known as ''Ms P'', was charged under the Health
Practitioners Competence Assurance Act 2003, in relation to
alleged failures in her care of Sara Gutzewitz and her son
Francis (Frankie), between January 20, 2010, and February 7,
2010.
The allegations centre around Ms P's actions during and
immediately after Frankie's birth on February 7, 2010, when
she said she had an unusually severe episode of
supra-ventricular tachycardia (SVT), causing her heart to
race and leaving her feeling faint.
While Ms P had previously experienced SVT, she said it had
not affected her ability to provide midwifery care before
February 2010.
Ms P said she began to feel unwell before Frankie's birth,
called for assistance and then asked the assisting midwife,
Valerie Drake, to remain in the room following Frankie's
birth as she had to leave.
However, that was disputed.
Since the incident, Ms P had formalised a management plan,
which included clear communication about her condition with
expectant mothers at their first meeting.
Director of proceedings Aaron Martin said in Ms Gutzewitz's
case Ms P failed to communicate her medical condition before
the labour; her unwellness during the labour; her requirement
for Ms Drake to look after Ms Gutzewitz and her son; or that
she was leaving the room. He contended, whether viewed
separately or cumulatively, her actions amounted to
professional misconduct.
For the tribunal to find the charges proven, it had only to
be satisfied there was a ''significant departure from
acceptable professional standards warranting sanctions''.
However, Anita Miller, counsel for Ms P, argued given the
seriousness of the charge, the burden of proof needed to be
higher.
Mr Martin said by defending the charge, Ms P was attempting
to blame a ''clear departure'' from the standards - resulting
in Ms Gutzewitz feeling ''abandoned by her LMC (lead
maternity carer) at a critical time - on her underlying
medical condition which she ''kept to herself, before, during
and after Ms Gutzewitz's labour''.
''Her communication failures amount to professional
misconduct.''
Mr Martin said Ms P was aware she had SVT since at least
2003, was physically capable of communicating with Ms
Gutzewitz, her family and other staff to the ''limited extent
necessary to meet the requisite professional standard'', yet
failed to do so.
Saying Ms P could do nothing about her SVT but would
communicate better in future could not sit alongside her
''refusal to accept her communication in this case was a
significant departure from professional standards''.
Ms P's ''acts and omissions'' were sufficiently serious to
warrant a disciplinary sanction to protect the public,
maintain professional standards and punish the practitioner.
Ms Miller argued having regard to all of the circumstances
her conduct could not be said to ''fall so seriously short of
the acceptable it amounts to misconduct''.
The key matter in dispute was whether Ms P left the Gutzewitz
family alone immediately after Frankie's birth, without first
ensuring adequate midwifery care was available.
''It is submitted that when the evidence is considered in
totality there is considerable uncertainty in a number of
witness accounts ... given the seriousness of the charge, and
consequently the high burden of proof on the Director of
Proceedings, [Ms P] should benefit from any doubt as to what
occurred.''
Ms Miller said even if the tribunal found the charges proven,
it was a ''two stage test'', the second of which was to
determine whether the conduct was ''significant enough'' to
warrant disciplinary sanction. She submitted it was not.
''This is an unusual case. It's also a significant case and
it raises difficult questions about communications for
hundreds, if not thousands, of health practitioners with
health concerns.''
She argued even if the tribunal found the charges proven, it
could not be satisfied discipline was warranted.
''The case of professional misconduct cannot be made out and
as such the charge ought to be dismissed,'' Ms Miller said.
